Reimagining science communication in a time of change for social media

It is time to ask: are platforms like Twitter really the best places for conversations about issues of consequence for health?

13 years ago, as I was considering leadership positions in epidemiology, I thought it was important to find new ways of communicating about the science of public health. This led me to the still relatively new world of social media. At the time, social media seemed to hold much potential as a place for sharing the latest science, for making connections, and for helping engage with the public around issues of consequence for health. In the spirit of this engagement, I joined Twitter, Facebook, LinkedIn, and, later, Substack. I have used these platforms to communicate broadly, because I see translation as a core part of what we do in public health. I have long believed that a robust public conversation is central to generating the ideas that shape a healthier world.

The reach of social media and its capacity to foster connection and engagement is clear. At its best, social media has served as a focal point for the public conversation around issues that matter for health. Twitter, for example, offered the unique ability to conduct truly global conversations about core issues, in real-time. It created a scrum of 24/7 engagement that was often essential to understanding the present moment. From the Arab Spring to the Trump presidency to organizing against gun violence in the wake of the Parkland shooting to public health’s response to COVID-19, Twitter was a player in many of the most consequential stories of the last decade, shaping the public debate around key issues.

In recent years, however, I have begun to question whether the good of Twitter continues to outweigh the bad. The candidacy, and later presidency, of Donald Trump revealed Twitter as a potent source of misinformation and hate, amplifying the worst of the public discourse, inflaming social and partisan divides. It often felt over the past several years that Twitter was a convenient way for those with malintent to seed their ideas that then, more sober and curated media outlets could not resist amplifying.  Because of the platform’s design, it tends to reward the emotive and simplistic over nuanced considerations of ideas. It has also been possible in recent years to see how Twitter contributes to a climate in which performative statements often take the place of nuanced thought and debate. These statements can tend towards the moral grandstanding I have written about previously in this newsletter. Such “virtue-signaling” can distract us from the work of creating a healthier world by making us feel like we are making a difference when, in fact, we are only appearing to do so.

Twitter’s challenges reached a kind of culmination in October, when Tesla, Inc. and SpaceX CEO Elon Musk closed a $44 billion deal to buy the platform. Since then, he has made several dramatic changes to the company. Under Musk’s leadership, thousands of employees have left Twitter amid uncertainty over its new workplace culture and its policies on content moderation and speech. This week, Twitter suspended the accounts of several prominent journalists who had recently written about Musk, stating these accounts violated Twitter’s policies though failing to provide specifics on this claim. This decision appears to be arbitrary, and it directly counters statements from Musk just last month. This uncertainty reflects Musk’s philosophy about what he calls free speech but what has been characterized as greater tolerance for voices of misinformation, bigotry, and hate. Musk’s changes underscore the reality that Twitter, once a publicly held company, is now privately held, and, as such, lacks the regulatory constraints and oversight to which publicly held companies are subject. In its current form, Twitter is accountable primarily to the wishes of its new CEO, and recent weeks have shown that these wishes do not align with the creation of a public conversation that supports a healthier world. While Musk has long made provocative statements on Twitter, his recent tweet attacking Dr. Fauci and the practice of declaring pronouns reflects a willingness to embrace speech that is demeaning and potentially dangerous.

As long as Twitter is controlled by someone willing to cross these lines, it is hard to imagine how the platform can support a healthy public conversation. With this in mind, I have decided to pause my engagement with Twitter and suspend my personal account. This was a difficult decision to make. I still believe that communicating to the wider public is core to the work of public health, and to science more broadly. But the heart of science is nuance, careful thinking, and a process of reasoned inquiry, and the truth is that Twitter had been becoming less hospitable to these principles long before Musk acquired the company. This suggests that it is worth taking this moment to reflect on how we communicate science to the wider public, and on whether our engagement with social media continues to serve us well as we engage in the work of translation. Do places like Twitter represent the best possible medium for communicating the ideas and data that are core to public health?

When social media was new, it was hard not to engage with something that seemed to offer so much. Now social media has lost its novelty and much of its early promise. We have seen its pitfalls and the diminishing returns engagement with this medium can bring. This has created a moment in which it is possible to pause, for the first time in nearly two decades, and really think about whether, as Ian Bogost argued in The Atlantic, the age of social media is ending. This is not to say that influential social media platforms will go away, but rather that we may, collectively, rethink whether they are the right place to have complex conversations about issues of consequence.

In engaging in this reflection, it is important to remember that social media platforms like Twitter are, fundamentally, service providers. Just as we might choose whether or not to buy a product from a company based on that company’s values, it makes sense that we would apply the same standard to Twitter. It is common for individuals and organizations to divest from companies due to a misalignment of values. When companies exploit their workers or do business in countries that oppress citizens or give money to politicians whose actions do not support the advance of progress, it is the right of any consumer to deny such companies their business.

Under its new leadership, all signs point to Twitter no longer being as conducive as it once was to the conversations that make the world a better place. For this reason, it is appropriate to reconsider giving Twitter our business, at least for a while. Just as choosing to utilize a service provider is conditional, dependent on the values of that company, choosing not to use a company’s services can also be subject to change if conditions at that company improve. It would be welcome indeed if Twitter were to change course and became better aligned with the values of a progressive vision of a better world. If circumstances do change, it will be worth revisiting the decision to take a step back from Twitter. In the meantime, however, such a step strikes me as necessary and right, reflecting an engagement with the commercial determinants of health, about which I have recently written.

In taking a step back from Twitter, I do not mean to imply that those who choose to remain on the platform lack good reasons for doing so. Twitter has become a powerful tool for amplifying the voices of many groups which have long been overlooked, helping build community and influence the public debate. It would be a shame if changes at Twitter caused the dissolution of these online communities. It is also true that many in public health have long used Twitter to disseminate data, engage with the public, and advance a conversation that supports a healthier world. There are many in public health who continue to be effective on Twitter and for whom the calculus of engagement is different. I respect the right of each person working in our field to make their own decisions about whether to keep engaging with Twitter, carefully weighing the pros and cons.

I also realize that in even writing about a decision to suspend activity on Twitter I run the risk of seeming perhaps performative, engaging in the kind of virtue-signaling I have criticized in this newsletter. Yet I thought it important to explain my reasoning here, given Twitter’s intersection with the broader issues of public health communication and speech in the present moment. Leaving Twitter over its owner’s speech could be misinterpreted as, on some level, rejecting a certain vision of free speech. Bearing in mind this newsletter’s focus on the importance of free and open debate as a tenet of the small-l liberalism that supports a healthy world, it is important to address this directly. Long before I began writing The Healthiest Goldfish, I wrote a Dean’s Note on how to balance free speech with maintaining a respectful, inclusive academic conversation. In that piece, I argued that academic communities should not provide a platform to speech that is not subject to rebuttal, speech that seeks to incite violence, or speech that traffics in falsehood. Musk’s tweet about Dr. Fauci is, in my assessment, speech not based in fact and speech that could indeed lead to the risk of violence. Given that this is the sort of speech Musk sees fit to broadcast to his over 100 million Twitter followers, there is little choice but to conclude it reflects his core values—values which are inimical to the values of public health. In public health, we seek to improve the health of populations, with special care for the marginalized and vulnerable. This means using our voices to elevate civility, facts and data, and a commitment to rejecting messages of opprobrium and hate. In the past, such messages could indeed be found on Twitter given its role as a public forum, but they were not embraced by its leadership. Now that this seems to have changed, it is right, I think, to reevaluate our engagement with the platform.

I should also note that, as Dean of a school of public health, I have an institutional responsibility to evaluate the values of the companies with which we do business, including social media companies. To that end I have worked with our team at the School to similarly suspend our School’s Twitter account. When I reflect on this as dispassionately as possible,  fundamentally I have come to feel that when a social media platform loses sight of the principles of liberalism, it becomes less hospitable to the kinds of conversations that shape a healthier world. Under its new leadership, Twitter appears to have become unmoored from these liberal principles. It seems appropriate, then, to pause engagement with the platform, guided by our values as a field. In doing so, we are reminded of what is truly fundamental in our work—respect, civility, and a commitment to continuing to have the conversations that advance a healthier world, whether online or off.